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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTER OF LUBBOCK, INC.

MEDICARE: COMMUNITY HEALTH CENTER OF LUBBOCK, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689855819
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTER OF LUBBOCK, INC.
Provider Business Mailing Address
First Line : 1610 5TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-2622
Country : US
Telephone Number : 806-765-2611
Fax Number : 806-687-5826
Provider Business Practice Location Address
First Line : 1610 5TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-2622
Country : US
Telephone Number : 806-765-2611
Fax Number : 806-319-9063
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MICHAEL SULLIVAN
Credential :
Telephone Number : 806-765-2611
Provider Enumeration Date : 11/15/2007
Last Update Date : 02/14/2022

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Directions to “COMMUNITY HEALTH CENTER OF LUBBOCK, INC. ” Practice Location

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